Dispelling nutrition myths, ranting, and occasionally, raving

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Are prenatal vitamins a waste of money?


Last week the news that pregnant women don’t need vitamin supplements seemed to be all over social media. The articles were based on this review article published in the Drug and Therapeutics Bulletin. The authors concluded that based on the evidence, much of which was from research in developing nations, that women (in Britain) do not need to take prenatal vitamins.

They reached this conclusion based on examining studies of the effects of folic acid, vitamin D, iron, vitamin C, vitamin E, and vitamin A supplementation on birth outcomes. While they concluded that multivitamin supplements are unnecessary for women during pregnancy, they stated that there was strong evidence to support women taking folic acid supplements and vitamin D supplements during pregnancy.

The message that came across most strongly (from the news articles) to me was that women are being shamed into purchasing vitamins that they can ill-afford, and don’t need, under the guise of wanting the best for their baby. The implications of these news articles concern me.

Firstly, women should be aware that many pharmacies (in Canada at least) have prenatal programs through which pregnant women can receive free multivitamin supplements, amongst other things. An inability to afford multivitamins should not prevent women from receiving them. Let’s not make this about drug companies trying to make money from poor women desperate to do the best for their unborn children. This should be about doing the best for women and their unborn children.

Okay, now that, that’s out of the way… I worry that the message that women should still be taking folic acid supplements and vitamin D supplements (and not just pregnant women I should add as most women of childbearing age should be taking folic acid supplements and most women in North America at least, should be taking vitamin D during the winter months) will be lost amid the cry that multivitamins are unnecessary. The message is not that all vitamin supplements are unnecessary for most Western women during pregnancy, just that the current evidence doesn’t support the use of multivitamins.

I’d also like to note that the researchers were focussing on birth outcomes. The conclusion that multivitamins are unnecessary was based on whether or not mums gave birth to healthy full-term babies. The authors did not take into consideration any potential long-term benefits maternal supplementation might have on their children. The authors did not take into consideration benefits that multivitamin supplementation might provide to mums. They did note that multivitamins can lower the mums risk of anemia, but as that didn’t seem to affect birth outcomes iron supplementation was deemed unnecessary. There are many other vitamins and minerals in multivitamins that the authors didn’t look at. Quite likely there’s not enough research on them to make a call either way. Regardless, the needs of pregnant women, not just their babies, should be taken into consideration when determining whether or not supplements are needed. Not all mums are going to get all the nutrients they need from food. Especially if they’re suffering from “morning” sickness. Perhaps not all mums will benefit from taking multivitamins. However, some very well may, and I think it would be a shame to tell them that they’re “wasting their money”.

Finally, as my friend Mark (who asked me to write about this topic) mentioned, taking two pills is more effort than taking just one. If it’s still being recommended that women take folic acid and vitamin D during pregnancy then they may as well just get those nutrients from a prenatal multivitamin rather than buying separate bottles of two supplements and having to remember to take both pills. It may be ever so slightly less expensive to buy vitamin D and folic acid instead of a multivitamin but I can’t even be certain of this because there was no folic acid for sale at my local grocery store when I went to price them all out. Which raises the issue of availability as well.

Women shouldn’t be made to feel guilty about not being able to afford a prenatal multivitamin. They also shouldn’t be made to feel like they’re wasting their money by buying them.


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Aloe vera: healing or harmful?


Image by Andreas Issleib on flickr. Used under a Creative Commons Licence.

A little while ago when I was looking for blogspiration a friend told me to take a look at a certain “nutritionist” on twitter. Since then, I’ve had her on my back burner because she certainly looked like she would have some good blog fodder (cured her incurable illness through diet) but I couldn’t be bothered to look through all her posts. Well, today’s the day I move her to the front burner.

I was reading her post on the healing properties of aloe. I found myself hoping that she would provide a balanced picture because I didn’t really want to write about aloe. Sadly, she did not, so here we are. As I feel that simply extolling the virtues of a food, without providing cautions is irresponsible, even if you don’t have a regulatory body protecting the public from you. Sorry, sorry, I digress.

In her post she writes about the magical properties of aloe: anti-viral, anti-bacterial, anti-inflammatory. Unfortunately, there she didn’t link to any research so I can’t comment on the quality of the studies used to make these claims. As far as I can tell, to date there’s been very little (if any) research on human subjects. However, some in vitro studies and animal have shown some promise when it comes to the anti-viral (1, 2) and anti-microbial (3, 4) properties of aloe vera. Of course, based on the current research, there’s no way to know what dose or form of aloe would (if at all) be effective in humans. It’s entirely possible that oral ingestion of aloe would not have any positive benefits in relation to viruses and bacteria.

Some mouse studies and in vitro have shown promising wound healing and anti-inflammatory effects of aloe vera (when administered both topically and orally) (5, 6). Again, there has yet to be any conclusive research done in humans.

Okay, it sounds a bit promising but… Then come the concerns. Before you start adding a handful of aloe vera plant to your smoothie you should be aware that the exterior portion of the leaf has a laxative effect. There are other longer lasting concerns about aloe vera consumption than diarrhea. My friend Helen has written about many of them on her blog Food and Nonsense. These include a risk of cancer and impaired liver function. Over at Examine, the only conclusive research they’ve found so far for aloe supplementation is for increased intestinal motility (i.e. to combat constipation). The Mayo Clinic provides a long list of cautions against the ingestion of aloe vera products, including the risk of inducing uterine contractions in pregnant women. I’ve also blogged about the consumption of aloe vera juice in the past.

I believe that my final statement in that post stands the test of time: Just because it’s “natural” doesn’t mean it’s good for you.


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Diabetes management by Huff Post


I found it a little alarming that Huffington Post would publish an article containing medical advice on diabetes management by a naturopath. Not surprising, but alarming.

To be perfectly honest, most of her advice wasn’t terrible (therein lies the worst aspect of naturopathy, it’s often truth laced with completely unscientific bullshit).

Managing carbohydrate intake and cutting back on foods such as white bread can be beneficial. Although, you don’t necessarily have to completely remove all of these foods from your diet and other foods can also lead to spikes in blood sugar.

Getting daily exercise is also great; for anyone, not just someone with type 2 diabetes. Although, touting it as the tool for weight loss is misleading. Most weight loss results from changes in the kitchen, not changes in the gym.

The supplement suggestions make me extremely uncomfortable for several reasons. First of all, naturopaths sell supplements in-house and this is a massive conflict of interest. A medical professional should not profit from the “treatment” they provide to a patient. Secondly, there is insufficient scientific evidence to support supplementation with the remedies she recommends.

The most alarming aspect of this article, in my opinion, is that it’s providing medical advice via a publicly posted article. Treatment of type 2 diabetes (or any other medical condition) should be undertaken with appropriate medical supervision. Without first consulting with your doctor and/or pharmacist there’s no way to know what effect the supplements she recommended might have on an individual. They may be contraindicated for a medication that a person is taking or they may cause other side effects. Even making dietary changes should be done in consultation with your primary healthcare provider. If you’re taking medication for diabetes, making changes to the amount and timing of carbohydrate you’re consuming can affect the way in which your medication works.

If you suspect that you have diabetes, please see your doctor or nurse practitioner for a diagnosis. If you’re currently on medication for diabetes please consult with any/all of the aforementioned medical professionals before making any drastic lifestyle changes and certainly before undergoing any additional supplementation.


Hollywood juice bar owner’s diet analyzed


Photo of Green Juice by Marten Persson on Flickr. Used under a Creative Commons Licence.

In case you missed it last week, the Internets got their collective panties in a twist about this article sharing a typical day of food for the founder of Moon Juice.

Moon Juice, for those such as myself who are not in the know, is ostensibly the most popular juice bar in LA.

Pardon me for not being surprised that her diet includes ridiculous things that I’ve never heard of before and am not entirely convinced are actually food. Things like Brain Dust and quinton shots. Ugh.

People immediately began decrying her diet. Just for fun, I decided to do a completely unscientific analysis of the nutrient content of her food to see just how her food stacks up when compared to a diet of recognizable food items. I used the nutritional info listed for the products on the Moon Juice website where I could. For everything else I just googled for nutrition information. I only looked at macronutrients, so it remains to be told how nutritious her diet is in terms of micronutrients.

Breakfast: 307 kcal, 13g CHO, 17.5g fat, 27g protein, 7g fibre, 3g sugar

Snack: 284 kcal, 31.1g CHO, 12g fat, 2.5g fibre, 8g sugar, 9g protein

Lunch: 265 kcal, 20g fat, 10.7g CHO, 4g fibre, 5.9g sugar, 6.3g protein

Snack: 353 kcal, 36.9g CHO, 8.5g fibre, 21.7g sugar, 22.5g fat, 7g protein

Snack: 280 kcal, 30g CHO, 6g fibre, 6g sugar, 4g fat, 26g protein

Supper: 50 kcal, 9g CHO, 0.5g fibre, 0.7g sugar, 0.6g fat, 5g protein – Potentially an entire day’s worth of sodium in this meal alone!

Snack: (Nutrition info for Heart Tonic is unknown, estimating the nutrient values for the chocolate based on single servings of all the ingredients mentioned) 174 kcal, 5g CHO, 3g fibre, 4.5g fat, 21g protein – I find it hard to believe that this chocolate is remotely palatable without any added sugar but maybe that’s just me.

Totals for the day: 1713 kcal, 135.7g CHO, 81.1g fat, 101.3g protein, 31.5g fibre, 45.3g sugar

I must confess, I’m a little disappointed that her diet didn’t show any glaring imbalances. Overall, it’s maybe a little low in carbs, and a little high in protein and fat and sugar. But essentially, it’s actually fairly well balanced.

I would be a little concerned about calcium, vitamin D, and vitamin B12 consumption for someone following this diet. Also, the sodium is quite high. Not knowing her energy requirements it’s hard to say whether or not 1700 kcal is adequate. That would depend on her height, weight, level of activity, and resting metabolic rate.

Even though this diet is not horribly balanced I still wouldn’t recommend it to anyone. Why? Well, variety is very important in a balanced diet. Based on the fact that she seems to eat essentially the same things every day she’s quite likely not getting all of the micronutrients that she needs. She may also be getting excessive amounts of others through her supplements.

Speaking of the supplements, there’s quite a few ingredients in there that are questionable at best. I don’t think that anyone can say with any degree of certainty that they’re safe to consume on a regular basis. Although one can say with a fair degree of certainty that they won’t live up to the claims. They’re definitely not worth the hefty price tags. Although if you’re willing to spend $55 for a 25 serving jar of Brain Dust then you probably need all the help you can get maintaining “healthy systems for superior states of cognitive flow”.




Herbalife part 2


I received quite the response to my Herbalife post last week (thanks guys!). A number of comments on both the post and facebook made me think that I should do a brief follow-up. I got so caught-up in exploring the sketchy dynamic of the company itself that I spent very little time looking at the products they’re peddling.

Naturally, it’s always best to get your nutrition from whole foods. While many supplements and protein snacks are generally benign, there are some supplements that can actually cause considerable harm. We know that the supplement industry is not well regulated and there have been a number of exposes in the past few years of supplements containing ingredients other than those listed in the package. Well, it turns out that Herbalife supplements may also warrant closer scrutiny.

A reader was kind enough to send me the titles to some articles in the Journal of Hepatology to read. One of these, from 2007 was entitled: Slimming at all costs : Herbalife-induced liver injury. This article shares a number of cases in which severe liver injury was determined to have resulted from the use of Herbalife products. Unfortunately, because the users were taking anywhere from 3 to 17 different Herbalife products, investigators were unable to attribute the injury to a particular product. While a paper “revisiting” these claims against Herbalife was published in the World Journal of Hepatology in 2011, it’s hard not to be suspicious of their conclusion that the Herbalife products could not be linked to the cases of liver toxicity as the authors were all affiliated with Herbalife.

It’s difficult for me to properly assess the ingredients in Heralife products as their website lacks nutrition and ingredient information and I lack a lab to analyze the composition of the supplements (and the desire to use my money to purchase them). However, just looking at some of them from the website raises some questions. There’s a “herbal tea concentrate” listed under weight management. Yet, the description states “A delicious tea blend of green tea and orange pekoe…”. Green tea and orange pekoe tea are not herbal teas. Green tea supplements have also been linked to liver failure so I find this product concerning. There’s also a mysterious product called “Total Control”, “Liftoff” which is essentially Redbull in effervescent tablet form, “Herbalife24” which supposedly restores through antioxidants (which research is showing may cause more harm than good in supplement form) and vitamin A (which can be toxic in high supplemental doses).

These are just a few Herbalife products. They may be perfectly harmless, although it’s extremely unlikely that they’re actually beneficial. However, without knowing what’s actually in them I would never take the risk of purchasing and ingesting them. Save your money and your health and don’t buy risky supplements.